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Demand for human radiologists is at an all-time high

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Re: Demand for human radiologists is at an all-time high

#361

Post by seesthruya »

aabajian wrote: post #209

I'm an interventional radiologist with a master's in computer science. People outside radiology don't get why AI hasn't taken over. Can AI read diagnostic images better than a radiologist? Almost certainly the answer is (or will be) yes. Will radiologists be replaced? Almost certainly the answer is no. Why not? Medical risk. Unless the law changes, a radiologist will have to sign off on each imaging report. So say yo…

I'm a diagnostic radiologist with 20 years clinical experience, and I have been programming computers since 1979. I need to challenge one of your core assumptions.

> Can AI read diagnostic images better than a radiologist? Almost certainly the answer is (or will be) yes.

I'm sorry, but I disagree, and I think you are making a wild assumption here. I am up to date on the latest AI products in radiology, use several of the, and none of them are even in the ballpark on this. That vast majority are non-contributory.

It is my strong belief that there is an almost infinite variation in both human anatomy and pathology. Given this variation, I believe that in order for your above assumption to be correct, the development of "AGI" will need to happen.

When I interpret a study I am not just matching patterns of pixels on the screen with my memory. I am thinking, puzzling, gathering and synthesizing new information. Every day I see something I have never seen before, and maybe no one has ever seen before. Things that can't and don't exist in a training data set.

I'm on the back end of my career now and I am financially secure. I mention that because people will assume I'm a greedy and ignorant Luddite doctor trying to protect my way of life. On the contrary, if someone developed a good replacement for what I don, I would gladly lay down my microphone and move on.

But I don't think we are there yet, in fact I don't think we're even close.

Re: Demand for human radiologists is at an all-time high

#362

Post by seesthruya »

n8henrie wrote: post #303
cogman10 wrote: post #214

Earlier quoted context omitted.

Doesn't most of the stuff a radiologist does get double checked anyways by the doctor that orders the scan in the first place? I guess not a more typical screening scan like a mammogram. However, for anything else like a CT, MRI, Xray, etc. I expect the doctor/NP that ordered it in the first place will want to take a look at the image itself and not just the report on the image.

As an ER doc I look at a lot of my own studies, because I'm often using my interpretation to guide real-time management (making decisions that can't wait for a radiologist). I've gotten much better over time, and I would speculate that I'm one of the better doctors in my small hospital at reading my own X-rays, CTs, and ultrasounds. I am nowhere near as good as our worst radiologist (who is, frankly... not great). It…

As a working diagnostic radiologist in a busy private practice serving several hospitals, this has been my experience as well.

We have some excellent ER physicians, and several who are very good at looking at their own xrays. They also have the benefit of directly examining the patient, "it hurts HERE", while I am in my basement. Several times a year they catch something I miss!

But when it comes to the hard stuff, and particularly cross-sectional imaging, they are simply not trained for it.

Re: Demand for human radiologists is at an all-time high

#363

Post by seesthruya »

epcoa wrote: post #257
aabajian wrote: post #209

I'm an interventional radiologist with a master's in computer science. People outside radiology don't get why AI hasn't taken over. Can AI read diagnostic images better than a radiologist? Almost certainly the answer is (or will be) yes. Will radiologists be replaced? Almost certainly the answer is no. Why not? Medical risk. Unless the law changes, a radiologist will have to sign off on each imaging report. So say yo…

For real though how close are we to a product that takes an order for an ED or inpatient CT A/P, protocols it then reads the images and can read the chart and spits out a dictated report without any human intervention that ends up usable as is even 90% of the time.

We are not close at all.

Re: Demand for human radiologists is at an all-time high

#364

Post by cowsandmilk »

KnuthIsGod wrote: post #353

I sent a lady today to a radiologist for a core biopsy of a likely malignancy. And a man to a radiologist for a lumbar perineural injection. And a person to a radiologist for a subacromial bursa injection. And a month ago I sent a woman to a radiologist to have adenomyosis embolised. Also talked to a patient today who I will probably send to a radiologist to have a postnephrectomy urinary leak embolised. Is an LLM go…

Interventional radiology is clearly different and requires more training than plain radiology reading images.

Re: Demand for human radiologists is at an all-time high

#365

Post by seesthruya »

maz1b wrote: post #8

As a doctor and full stack engineer, I would never go into radiology or seek further training in it. (obviously) AI is going to augment radiologists first, and eventually, it will start to replace them. And existing radiologists will transition into stuff like interventional radiology or whatever new areas will come into the picture in the future.

If you believe this is true, why stop at radiology? Couldn't the same be said for every other non-surgical specialty?

Re: Demand for human radiologists is at an all-time high

#366

Post by sokoloff »

jayknight wrote: post #299
captainkrtek wrote: post #291

Earlier quoted context omitted.

Id be more concerned about the false negative. My report says nothing found? Sounds great, do I bother getting a 2nd opinion?

You pay extra for a doctor's opinion. Probably not covered by insurance.

It sounds fairly reasonable to me to have to pay to get a second opinion for a negative finding on a screening. (That's off-axis from whether an AI should be able to provide the initial negative finding.)

If we don't allow this, I think we're more likely to find that the initial screening will be denied as not medically indicated than we are to find insurance companies covering two screenings when the first is negative. And I think we're better off with the increased routine screenings for a lot of conditions.

Re: Demand for human radiologists is at an all-time high

#367

Post by cyrillite »

aabajian wrote: post #209

I'm an interventional radiologist with a master's in computer science. People outside radiology don't get why AI hasn't taken over. Can AI read diagnostic images better than a radiologist? Almost certainly the answer is (or will be) yes. Will radiologists be replaced? Almost certainly the answer is no. Why not? Medical risk. Unless the law changes, a radiologist will have to sign off on each imaging report. So say yo…

I am actively researching this friction and others like it. I would love it if you happened to have recommendations for literature that 3rd parties can use to corroborate your experience (I’ve found some, but this is harder to uncover than I expected as I’m not in the field)

Re: Demand for human radiologists is at an all-time high

#368

Post by avh02 »

UltraSane wrote: post #305
kbos87 wrote: post #277

Earlier quoted context omitted.

This is like saying that self-driving cars won't ever become a thing because someone behind the wheel needs to be to blame. The article cites AI systems that the FDA already has cleared to operate without a physicians' validation.

Tesla still hasn't accepted liability for crashes caused by FSD. They in fact fight any such claims in court very vigorously.

Tesla isn't the north star here

Re: Demand for human radiologists is at an all-time high

#369

Post by sokoloff »

seesthruya wrote: post #361
aabajian wrote: post #209

I'm an interventional radiologist with a master's in computer science. People outside radiology don't get why AI hasn't taken over. Can AI read diagnostic images better than a radiologist? Almost certainly the answer is (or will be) yes. Will radiologists be replaced? Almost certainly the answer is no. Why not? Medical risk. Unless the law changes, a radiologist will have to sign off on each imaging report. So say yo…

I'm a diagnostic radiologist with 20 years clinical experience, and I have been programming computers since 1979. I need to challenge one of your core assumptions. > Can AI read diagnostic images better than a radiologist? Almost certainly the answer is (or will be) yes. I'm sorry, but I disagree, and I think you are making a wild assumption here. I am up to date on the latest AI products in radiology, use several of…

Can a human reliably carefully study for hours on end imaging from screening tests (think of a future world where whole-body MRI scanning for asymptomatic people becomes affordable and routine thanks to AI processing) and not miss subtle anomalies?

I can easily imagine that humans are better at really digging deeply and reasoning carefully about anomalies that they notice.

I doubt they're nearly as good as computers at detecting subtle changes on screens where 99% of images have nothing worrisome and the priors are "nothing is suspicious".

I don't want to equate radiologists with TSA screeners, but the false negative rate for TSA screening of carryon bags is incredibly high. I think there's an analog here about the ability of humans to maintain sustained focus on tedious tasks.

Re: Demand for human radiologists is at an all-time high

#370

Post by DonsDiscountGas »

lomase wrote: post #5

In 2016, Geoffrey Hinton – computer scientist and Turing Award winner – declared that ‘people should stop training radiologists now’. If we had followed every AI evengelist sugestion the world would have collapsed.

Definitely an aggressive timeline but it seems like the biggest barrier to AI taking over radiology will be legal. Spending years training for a job which only continues to exist because of government fiat, which could change at any time, seems like a risky choice.
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